skip to main content

Familial Mediterranean fever — SCE Rheumatology MCQ

Instant feedback + full explanation. One question, done properly.

ModeratePregnancy and rare rheumatic diseaseFamilial Mediterranean feverSCE Rheumatology

A 33-year-old woman has recurrent self-limiting fever with abdominal pain. Examination shows there is transient ankle synovitis. Investigations show family history suggests autosomal recessive autoinflammation. The diagnosis is established and symptoms remain clinically important despite initial supportive measures. There is no contraindication to disease-modifying or anti-inflammatory escalation. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Colchicine

Colchicine is the best answer because colchicine is the most appropriate next step for familial mediterranean fever in this clinical setting. Bisphosphonate therapy is a plausible distractor, but it does not account for the key discriminator in the stem. Start methotrexate with folic acid and Avoid live vaccines in exposed infant would be more appropriate in a different clinical pattern or at another point in the pathway, while Mycophenolate mofetil is suboptimal for this presentation. Clinical pearl: rheumatology management is generally treat-to-target, but infection risk, pregnancy plans and shared-care monitoring often determine the safest answer.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/musculoskeletal-conditions